Quantitative evaluation of knee cartilage and meniscus destruction in patients with rheumatoid arthritis using T1ρ and T2 mapping

ObjectiveTo calculate T1ρ and T2 values of articular cartilage and menisci in knee joints of patients with RA, and compare the values between RA patients and healthy volunteers, to gain insight into the pathogenesis of cartilage and meniscus degradation in patients with RA.Materials and methodsNine patients with RA and knee joints symptoms were enrolled in the study, twenty healthy volunteers without knee joint diseases were included as controls. Sagittal fat-saturated T1ρ and T2 mapping images were obtained on a 3T MR scanner (GE750, GE Healthcare, Waukesha, WI), using a dedicated 8-channel knee coil. In the T1rho mapping sequence, the amplitude of the spin-lock pulse was 500 Hz, spin lock durations = 10/20/30/50 ms. In the T2 mapping sequence,TR/TE were 1794/6.5, 13.4, 27, 40.7 ms. Both sequences were performed with the following parameters: flip angle (FA) = 90°, matrix: 320 × 256, FOV: 16 × 16 cm², slice thickness: 3 mm, bandwidth: 62.5 kHZ, and a total scan time of 5:11 min. T1ρ- and T2-mapping images were used for the segmentation of the articular cartilage of the patella, femoral trochlea, medial and lateral femoral condyle, medial and lateral tibial plateau. These images were also used for the segmentation of the anterior and posterior horns of the medial and lateral menisci with livewire semi-automatic segmentation algorithm of MATLAB. A Mann–Whitney U test was performed to compare the T1ρ and T2 values of the above mentioned regions between the two groups.ResultsT1ρ (Z = −3.913 to −2.121, P = 0.000–0.034) and T2 (Z = −3.866 to −2.216, P = 0.000–0.026) values of knee cartilage in patients with RA were higher than that in healthy volunteers, except the cartilage of the patella (T1ρ: Z = −1.273, P = 0.203,T2: Z = −0.236, P = 0.814) and lateral tibial plateau (T1ρ:Z = −1.037, P = 0.317). The T1ρ (Z = −1.462 to 0.572, P = 0.095–0.908) and T2 (Z = −1.461 to 0.278, P = 0.153–0.764) values of medial and lateral menisci showed no difference between the two groups.ConclusionPatients with RA exhibit diffuse knee cartilage destruction in the medial and lateral tibiofemoral joints and in the femoral trochlea. However, we found no increase in T1ρ and T2 values in menisci, this finding warrants further investigation.     

MRI增强T1WI BRAVO与T2WI FLAIR CUBE诊断脑膜炎性病变的对比研究

目的：评价MRI增强T1WI BRAVO（T1WI FLAIR容积扫描）、增强T2WI FLAIR CUBE（T2WI FLAIR容积扫描）两种扫描序列及其联合应用在脑膜炎性病变诊断中的意义及临床应用价值。方法：收集我院2010年10月～2012年5月确诊脑膜炎性病变患者50例,并选择正常志愿者35例作为对照组,所有患者及志愿者均在常规T2WI FLAIR平扫后行T1WI BRAVO及T2WI FLAIR CUBE增强扫描,增强扫描两种方法交替进行,分析脑膜炎性病变在不同扫描序列上的影像学特征,对比两种增强方法独立应用及联合应用诊断脑膜炎性病变的敏感性及特异性。结果：50例患者中病毒性脑膜炎21例,结核性脑膜炎16例,化脓性脑膜炎13例。在病毒性脑膜炎中,增强T2WI FLAIR CUBE优于增强T1WI BRAVO和平扫T2WI FLAIR;在结核性脑膜炎中,增强T1WI BRAVO优于增强T2WI FLAIR CUBE和平扫T2WI FLAIR;化脓性脑膜炎中,增强T2WI FLAIR CUBE、增强T1WI BRAVO和平扫T2WI FLAIR 三者无差别。增强T1WI BRAVO和T2WI FLAIR CUBE显示脑膜炎性病变的敏感性分别是54．00％和64．00％,特异性分别为85．70％和88．60％,两者联合应用敏感性及特异性分别是78．00％和80．00％。结论：两种增强方法诊断脑膜炎性病变各有千秋,但增强T1WI BRAVO、增强T2WI FLAIR CUBE两种扫描序列联合应用能显著提高脑膜炎性病变的检出率和敏感性。     

Application of High-Resolution CUBE Sequence in Exploring Stroke Mechanisms of Atherosclerotic Stenosis of Middle Cerebral Artery

Background

This study aimed to analyze the vascular wall and atherosclerotic plaques of the middle cerebral artery (MCA) and compare their differences between patients with cerebral infarction and transient ischemic attack (TIA) using 3-dimensional fast-spin-echo T1-weighted sequence (namely CUBE).

MR 3D CUBE T2WI序列对膝关节解剖结构显示的价值

目的 探讨MR 3D CUBE T₂WI序列对膝关节解剖结构显示的价值。方法 应用GE Signa HDXt 3.0T超导型MR仪和相控阵线圈对病变组和对照组各30例膝关节行常规2D和 3D CUBE T₂WI序列扫描,比较两种序列图像显示半月板、前、后交叉韧带和关节软骨的解剖结构情况并进行优、良、差分级评价及统计学分析。结果 根据资料分析,3D CUBE T₂WI序列显示前、后交叉韧带和关节软骨方面优于常规2D序列,在半月板的显示方面不及常规2D序列（P均=0.000）。以优、良两级作为满足诊断要求的图像质量评价级别,病变组和对照组于3D CUBE T₂WI序列显示前、后交叉韧带的满意率均达100%,关节软骨对照组为93.33%、病变组为90.00%,而半月板对照组为30.00%、病变组为33.33%。结论 膝关节3D CUBE T₂WI 序列是一种对关节韧带、关节软骨显示敏感的序列,对于半月板的显示不及常规2D序列,建议结合临床选择使用。     

3D CUBE 脉冲序列在 MR 腮腺成像中的应用

目的：将3DCUBE序列应用于腮腺的MR常规扫描中,为初步筛查腮腺病变的定性诊断提供依据。方法：行冠位3DCUBET2WI压脂序列和冠位IR—FSE序列扫描腮腺,分别获取冠位3DCUBET2WI压脂序列扫描图像和冠位IR—FSE序列扫描图像,分别对腮腺的轴位TIWI和T2WI定位,并用同样的参数扫描获取图像。结果：3DCUBET2WI压脂序列对腮腺管主干及其分支显示的优良率为80％,较传统STIR序列扫描腮腺,对腮腺实质显示优良率的差异无统计学意义。结论：在常规腮腺的扫描中,应用3DCUBET2WI压脂序列代替IR—FSE序列,在不影响腮腺实质病变显示的情况下,能够显示腮腺管受病变累及的情况,从而为临床进行腮腺疾病的鉴别诊断提供重依据。     

MR 3D CUBE技术对膝关节前交叉韧带损伤的诊断价值

目的探讨MR 3D CUBE技术对膝关节前交叉韧带损伤的诊断价值。材料与方法对膝关节损伤拟行手术病人术前行MR扫描,以关节镜所见为参考依据,对80例患者86个膝关节行常规MRI序列扫描后加扫3D CUBE T2WI序列,运用AW4.4工作站对3D图像进行后处理重建。分别与关节镜术后结果进行对比分析,计算常规MRI序列及3D CUBE技术在诊断前交叉韧带损伤中的特异度、灵敏度及准确度。结果 3D CUBE T2WI序列在诊断前交叉韧带损伤特异度89%、灵敏度95%、准确度84%;常规MRI序列在诊断前交叉韧带损伤的特异度68%、灵敏度83%、准确度51%。结论 3DCUBE序列扫描时间短,图像可多角度任意旋转,可显示完整前交叉韧带,对前交叉韧带损伤的特异度、灵敏度及准确度较常规MRI序列高。     

3.0 T磁共振3D CUBE T2 WI抑脂序列对肛瘘的诊断价值

目的 探讨3.0T常规MRI T2 WI抑脂序列联合三维超长回波链采集FSE(3D CUBE) T2 WI抑脂序列对肛瘘患者的临床诊断价值.方法 回顾性分析33例经手术证实的肛瘘患者术前常规MRI T2WI抑脂序列及3DCUBE T2 WI抑脂序列资料.比较两种技术评价肛瘘分型、瘘管支数、内口总数、外口数目、肛周脓肿和瘘管整体的优势,并与手术结果相对照.结果 手术发现33例肛瘘中,经括约肌瘘14例,括约肌间瘘10例,括约肌外瘘8例,括约肌上瘘1例.瘘管支数52个,内口45个,外口48个,肛周脓肿30个.常规MRI T2WI抑脂序列与常规MRI T2WI抑脂序列联合3D CBUE T2WI抑脂序列肛瘘的分型准确率分别为78.8％ (26/33)和87.9％ (29/33),差别无统计学意义(JP＞0.05);瘘管支数显示率分别为71.2％(37/52)和90.4％ (47/52),内口总数显示率分别为71.1％ (32/45)和91.1％ (41/45),差异具有统计学意义(P＜0.05).两种技术显示外口数目和肛周脓肿与手术结果一致.结论 常规MRI T2WI抑脂序列联合3D CUBE T2WI抑脂序列能准确显示瘘管支数、内口总数和瘘管整体,优于常规MRI T2 WI抑脂序列,为临床术前提供更详尽的影像解剖信息.